Hernia in Pregnancy: A Common Problem

Hernia is a relatively common–and usually minor–complication of pregnancy. A hernia is a condition where an internal organ protrudes out of the space where it is normally contained. Most hernias involve a loop of intestine that protrudes through a weakened spot in the muscles of the abdominal wall.

The most common areas of the abdomen for a hernia in women are around the navel or bellybutton (an umbilical hernia) or low in the abdomen (either a femoral or inguinal hernia). An incisional hernia is one that occurs where an earlier surgery made a cut through the abdominal wall.

Pregnancy can cause a hernia because the muscles of the abdominal wall are being stretched as the uterus and baby grow. This stretching can weaken the muscle walls, allowing a loop of intestine to protrude. This loop may protrude through the muscle only occasionally, such as while you are standing, exercising, or lifting something, or when you cough or sneeze. Often, your hernia may be more apparent during the second trimester, but be less noticeable in the last trimester, when the uterus has grown high enough to come between the intestine and the weakened spot in the abdominal wall. Usually, a hernia during pregnancy may cause some discomfort, but many women have no symptoms outside of a visible lump or bump on their abdomen.

There is not much you can do to prevent a hernia from occurring during pregnancy. Generally, a woman who has had several pregnancies is at greater risk of developing a hernia than a woman in her first pregnancy. A pregnancy with twins or triplets is more likely to cause a hernia than a single baby.

Symptoms

If you develop a lump or swelling around your navel or anywhere else on your abdomen during your pregnancy, tell your midwife or doctor.

For some women, a hernia is completely painless even though it is visible. Other women have some discomfort or pain at the site of the hernia, especially when they lift anything heavy or when they cough or sneeze.

One serious problem that can occur with a hernia is if the loop of intestine becomes caught in the opening of the abdominal wall and twists. This can cut off the blood supply to that section of intestine or obstruct the bowels. The symptoms of this problem, called a strangulated hernia, are severe tenderness and pain in the area of the hernia. If you have severe pain at the site of a hernia, seek medical attention as soon as possible.

Treatment

The only effective way to correct a hernia is with surgery to repair the abdominal wall. Hernia repair surgery is simple, but it is rarely performed during a pregnancy. Most women are advised to wait until a few months after their delivery to repair their hernia. Many doctors also advise a woman to wait until after she has finished having all the children she wants.

Even if your hernia becomes strangulated, a doctor can usually push the loop of bowel back into its correct place so that surgery can be delayed until after you have your baby.

If you have pain when you cough or sneeze, you can help by supporting the hernia. Just use your hand to press on the hernia when you feel a cough or sneeze coming on. You should avoid lifting anything heavy for the duration of your pregnancy. You may need to wear a support such as a belly band or a truss over the hernia which can help keep everything in place and reduce any discomfort.

A hernia very rarely causes any problems during either a vaginal or cesarean delivery.

Hiatal Hernia

A hiatal hernia is a slightly different type of hernia that some women may develop during pregnancy or that pregnancy can worsen. At the top of your abdomen, there is a thin wall of muscles called the diaphragm that separates your intestines from your lungs. Your esophagus passes through an opening in the diaphragm called the hiatus and joins the stomach. In a hiatal hernia, your stomach has started to protrude up through the hiatus.

Symptoms of a hiatal hernia can include heartburn and acid reflux. Treatment includes eating smaller meals can help, as can some of the advice here.

Valerie DeBenedette is an experienced health and medical writer who lives about an hour north of New York City with a dog that is smaller than her cat. Her work has appeared in magazines, newspapers, newsletters, and on websites. She is a member of the National Association of Science Writers.